If confirmed by the Senate, Azar will oversee a $1-trillion department responsible for major health insurance programs, medical research, food and drug safety, and public health.

Azar served as deputy HHS secretary from 2005-2007 under President George W. Bush. Since his departure from the Bush administration, Azar worked for pharmaceutical giant Eli Lilly for 10 years, eventually rising to president of its key U.S. affiliate before leaving in January to start his own consulting firm.

Azar’s earlier HHS nominations in the Bush era sailed through the Senate. This time, he’ll face Democrats wary of the administration’s unyielding quest to repeal the Affordable Care Act.

Top Democrats in Congress were skeptical, but also said they hoped Azar would bring a shift from an ideological hard line on “Obamacare.”

“It’s time to turn over a new leaf at HHS,” said Sen. Chuck Schumer of New York, the Democratic leader.

But committee chairman Sen. Lamar Alexander, R-Tenn., cast Azar as a problem solver, saying “he has the qualifications and experience to get results.”

Insurers and for-profit hospitals also reacted positively, while the Public Citizen advocacy group likened Azar’s nomination to a “coup d’etat” by drug companies.

Americans consistently rank the high cost of prescription drugs among their top health care priorities, ahead of divisive issues like repealing former President Barack Obama’s health care law.

Trump has been a sharp critic of the industry. “The drug companies, frankly, are getting away with murder,” he said at a Cabinet meeting this fall. Prices are “out of control.”

In the spring, a Trump tweet sent drug stocks tumbling after the president said he was working on a new system that would foster competition and lead to much lower prices. In meetings with industry executives, however, Trump has focused on speeding up drug approvals, a cost-reducing tactic they would back.

Eric Hargan has served as acting HHS secretary since Price's Sept. 29 resignation amid questions over his use of private planes. Price used private charter flights on at least 10 trips with multiple segments, when in many cases cheaper commercial flights were available. Politico reported the total cost of the flights was over $1 million.

Price’s 231 day tenure is one of the shortest in American political history. Prior to serving in the Trump administration, Price was a U.S. representatives from Georgia’s 6th congressional district from 2005-2017.